How are theophylline doses managed in patients with status asthmaticus who smoke?

Updated: Jun 17, 2020
  • Author: Constantine K Saadeh, MD; Chief Editor: John J Oppenheimer, MD  more...
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Manage the theophylline dose in persons who quit smoking fewer than 6 months previously as if they are still smoking. Patients who smoke or those on phenytoin require higher loading and maintenance doses of theophylline. Other adverse effects can include nausea, vomiting, and palpitations.

The usual loading dose of theophylline is 6mg/kg, followed by maintenance doses of 1mg/kg/h in the emergent setting. In patients who smoke, the maintenance dose may be higher and the loading dose may be slightly higher. Patients on phenytoin should also receive increased maintenance doses of theophylline. Patients with liver disease or elderly patients may require a maintenance dose as low as 0.25mg/kg/h.

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